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Tag: Medicare Administrative Contractor (MAC)


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CMS proposes MAC changes 

September 9, 2024HME News Staff

WASHINGTON – CMS has posted a request for information to obtain public feedback on consolidating the Medicare Administrative Contractor (MAC) jurisdictions. The RFI also asks for feedback on awarding future MAC contracts with 10-year award periods of performance. The agency asks that those interested submit responses by email to MAC_Procurement@cms.hhs.gov within 30 days of the RFI publication date (Sept. 4). It says responses should be submitted as an email attachment in Microsoft Word and...

Medicare Administrative Contractor (MAC)


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Senators introduce bill to change LCD process

October 5, 2016HME News Staff

WASHINGTON - Two senators recently introduced a bill that seeks to improve the transparency and accountability of the local coverage determination (LCD) process performed by the Medicare Administrative Contractors (MACs). The Local Coverage Determination Clarification Act of 2016 would: require open and public meetings with the MACs that are on the record; require disclosure by the MACs of the rationale for an LCD and the evidence for that decision at the beginning of the process; provide stakeholders...

Advanced Medical Technology Association (AdvaMed), Legislation, Local Coverage Determination (LCD), Medicare Administrative Contractor (MAC)


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CMS limits scope of audits

September 1, 2015HME News Staff

WASHINGTON - For redeterminations and reconsiderations of claims denied following a post-payment review or audit, CMS has instructed the MACs and QICs to limit their scope to the reason the claim or line item was initially denied, according to a recent MLN Matters article. In the past, the MACs and QICs have had the discretion to develop new issues and review all aspects of coverage and payment related to a claim or line item. “In some cases, where the original denial reason is cured,...

Audit, Medicare, Medicare Administrative Contractor (MAC), QICs


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In brief: MACs miss standards, health spending stays low

January 10, 2014HME News Staff

BALTIMORE - Medicare Administrative Contractors (MACs) failed to meet one-quarter of CMS's performance standards, according to a new report from the Office of Inspector General (OIG). “Given the billion of dollars awarded to Medicare Administrative Contractors and the critical role they play in administering the Medicare program, effective oversight of performance is important to ensure that they are adequately processing claims,” the OIG states. The OIG based its findings on a performance...

101 Mobility, Active Healthcare, BGS Pharmacy Partners, Carolina's Home Medical Equipment, Centegra Health System, CMS, CPAP, Drive DeVilbiss Healthcare, Electronic Health Record (EHR), Finnegan Medical Supply, Golden Technologies, Hope Medical, IDS, Inspire Upper Airway Stimulation, Invacare, Medicare Administrative Contractor (MAC), Medline, Mergers & Acquisitions (M&A), Nova Medical Products, Numotion, Office of Inspector General (OIG), PharMerica, PMD demo, ResMed, Sunrise Medical, The CareGiver Partnership, Vantage Mobility International (VMI)


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MACs miss performance standards, OIG finds

January 10, 2014HME News Staff

BATLIMORE - Medicare Administrative Contractors (MACs) failed to meet one-quarter of CMS's performance standards, according to a new report from the Office of Inspector General (OIG). “Given the billion of dollars awarded to Medicare Administrative Contractors and the critical role they play in administering the Medicare program, effective oversight of performance is important to ensure that they are adequately processing claims,” the OIG states. The OIG based its findings on...

CMS, Medicare Administrative Contractor (MAC), Office of Inspector General (OIG), Performance standards


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Noridian reports overpayments on PMD rentals

August 22, 2013HME News Staff

FARGO, N.D. - Noridian Administrative Services has reported overpayments on some power mobility devices in Round 2 competitive bidding areas. Noridian says the problem stems from a system issue that led to DME MACs paying a higher rate than allowed under the program. Claims that meet the following criteria have been overpaid: processed on or after July 1, 2013, billed with the KJ modifier and submitted under a certain code (for a list of the codes, go here). Noridian says it will adjust these claims...

Competitive Bidding, Medicare Administrative Contractor (MAC), Noridian, PMD rentals


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MACs join forces to reduce denials

July 30, 2013HME News Staff

WASHINGTON - The Part A and Part B Medicare Administrative Contractors have formed a task force to educate on national issues of concern regarding improper payment errors, they have announced. The Comprehensive Error Rate Testing (CERT) A/B Contractor Task Force will hold its first teleconference Aug. 20. The task force affords providers the benefit of a “collaborative, consistent voice to reduce costly claim denials, as well as the CERT error rate,” according to a bulletin. The task...

Comprehensive Error Rate Testing (CERT), Denial Rate, Home Medical Equipment (HME), Medicare Administrative Contractor (MAC)


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